NICE reveals plans for dementia QOF expansion

NICE has published further details of plans to use QOF to improve the health of patients who care for people with dementia.

NICE: consultation on QOF indicators for 2014/15
NICE: consultation on QOF indicators for 2014/15

NICE launched a consultation on 14 proposed new indicators for the QOF 2014/15 on Monday, including four in the dementia clinical domain.

Targets for hypertension, CHD, diabetes, peripheral arterial disease and stroke are also being considered. If approved following the consultation and piloting, these indicators will form the proposed 'menu' of QOF targets for 2014/15 and will be passed to GP negotiators in the autumn.

The new dementia targets would see GPs paid to hold contact details for a carer on the records of people with dementia, keep a register of dementia carers who are patients of the practice, and assess their health annually.

GPs would also earn points for ensuring patients with a new diagnosis of dementia had visited a memory assessment service in the previous 12 months before diagnosis.

The plans were first announced in June 2012 but the latest consultation gives the full draft wording of NICE's proposed indicators.

The consultation also includes the first of a new type of QOF indicator called a 'tightly linked measure' (TLM). This new target, in diabetes, allows GPs to hit flexible targets depending on the patient in front of them.

As expected, a target for using ambulatory BP monitoring to confirm a diagnosis of hypertension is also included. It follows the 2011 update to NICE's hypertension guideline.

GPs and other stakeholders will now have until 4 February to give their views.

 

Details of NICE proposals for QOF 2014/15

Hypertension

  • The percentage of patients with a new diagnosis of hypertension after 1 April 2012 whose diagnosis was confirmed following ABPM.

Dementia

  • The percentage of patients with dementia with the contact details of a named carer on their record.
  • The practice has a register of patients who are carers of a person with dementia.
  • The percentage of carers (of a person with dementia) who have had an assessment of their health and support needs in the preceding 12 months.
  • The percentage of patients with a new diagnosis of dementia (after 1 October 2012) who have attended a memory assessment service up to 12 months before the date of diagnosis.

CHD

  • The percentage of patients 80 and over with coronary heart disease in whom the last blood pressure reading (measured in the preceding 15 months) is 150/90 or less.
  • The percentage of patients under 80 with coronary heart disease in whom the last blood pressure reading (measured in the preceding 15 months) is 140/90 or less.

Diabetes

  • The percentage of patients with Type 2 diabetes aged 40 years and over with successful lipid management defined as either:
    a) last recorded cholesterol in the preceding 12 months ≤ 4.0mmol/l
    b) last recorded cholesterol in the preceding 12 months > 4.0mmol/l and commenced on a moderate dose generic statin within 90 days of cholesterol recording
    c) last recorded cholesterol in the preceding 12 months > 4.0mmol/l and generic statin dose increased within 90 days of cholesterol recording
    d) or, last recorded cholesterol in the preceding 12 months > 4.0mmol/l and cholesterol lowering therapy changed to a different drug within 90 days of cholesterol recording.
  • The percentage of women with diabetes under the age of 55 years who have been given information and advice about pregnancy, conception or contraception tailored to their pregnancy and contraceptive intentions recorded in the preceding 15 months.
  • The percentage of women with diabetes under the age of 55 years who have a record of information and counselling about contraception, conception and pregnancy in the preceding 15 months.

Peripheral Arterial Disease

  • The percentage of patients 80 and over with a history of peripheral arterial disease in whom the last blood pressure reading (measured in the preceding 15 months) is 150/90 or less.
  • The percentage of patients under 80 with a history of peripheral arterial disease whose last recorded blood pressure reading (measured in the preceding 15 months) was 140/90.

Stroke and TIA

  • The percentage of patients 80 and over with a history of stroke or TIA in whom the last blood pressure reading (measured in the preceding 15 months) is 150/90 or less.
  • The percentage of patients under 80 with a history of stroke or TIA in whom the last blood pressure reading (measured in the preceding 15 months) is 140/90 or less.

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